Failures in mental health support service as “unprecedented” demand increases

Multiple students have spoken out about their experiences of systemic breakdowns in the service provided by Open Door, the University’s student support and mental health provision. It follows the news that spending on Open Door has not kept pace with rapidly rising demand over the last five years.

Open Door’s primary function is to support any student experiencing mental or emotional difficulties with custom aids that range from one-on-one counselling sessions to cognitive behavioural therapy.

However the service is not equipped to medicate or treat mental illness and its principle remit, according to Head of Student Support Peter Quinn, is to support students in order that they can “progress in [their] studies”.

Swati Kaladagi, who suffers from depression, anxiety and mild PTSD, attended a number of Open Door counselling sessions upon arriving at University in her first year, before being forced to miss an appointment due to ill health. Kaladagi claims she emailed to reschedule, but never heard back from her counsellor.

“They never contacted me again,” Kaladagi says. “I emailed to say I wouldn’t be able to make an appointment and wanted to reschedule and just never got a response. Now, I would follow up with that, but at the time – it was uni, it was scary; I just didn’t want to talk to people.”

When her mental health deteriorated later in the year, Kaladagi got back in touch with her counsellor who, she claims, was willing to arrange a session but directed her to other services to seek long term support that Open Door “weren’t able to provide”.

“I think it’s kind of unfair to people who start and then realise they need more help, and they’ve already built up a relationship with a counsellor and then they have to go and see a new one. I’ve been to see so many counsellors and that’s always the most difficult part, walking into a new session and getting to know this new person.”

Jill Ellis, Deputy Director of Student Support Services, clarified that the focus of Open Door is on “fairly short, brief engagements or interventions” orientated around supporting study, with a small number of students with serious health conditions being case managed. She said that in the majority of cases, students require between one and three sessions with an Open Door specialist.

Quinn confirmed that the Open Door team usually follows up on missed appointments. “It depends on your risk level,” he said, “so if you were very depressed and you were seeing someone from the Open Door team and you didn’t make the session then it would depend on the difficulties you were having but yes, you would be followed up, usually.”

Quinn also said that at “each interaction, every appointment someone has with the Open Door team they complete [a clinical questionnaire], and so no students would ever be let go of or moved forward if their scores were in the risk area”.

Another anonymous student went to Open Door upon arriving at University for counselling support. The student described their initial experience as “very positive”, but claims that when their condition worsened severely they were unable to get an appointment before the holidays, which “made me worse”.

“[Open Door] couldn’t offer me an appointment and this was with four weeks left of term,” the student said. “I went to the desk almost in floods of tears and said ‘please could I have an appointment, I’ve been here before’”.

“They said ‘we can put you on the waiting list, people do cancel, always have your phone on you and we’ll just ring you up as soon as we have a free appointment’, but that was the best they could do.”

“It is a fantastic system that you can just walk in and speak to someone,” the student said, “but then on the flipside they can’t [give help] where people really need it, that’s where the issue is – they don’t have the means to. There needs to be some kind of prioritisation system.”

The yearly percentage increase in spending on Open Door and demand for the service. Click right for more

The spending increase for Open Door in the five year period correlated with demand

Demand on the Open Door team has increased by 46 per cent between 2011 and 2015. Cuts to services in the city, and 18 month waiting times for NHS mental counselling and therapy, are thought to be among the causes.

Quinn said that demand “has increased at unprecedented levels”, but claims there are processes in place for cases of students in crisis. He stated that the average waiting time is “up to three weeks for an appointment. So 15 working days, unless you had a significant crisis or mental health difficulty that was serious, and that’s judged on a variety of factors, and you would be seen much quicker or advised to visit your GP, A&E or access advice via NHS Direct.”

“If there’s something that needs attention immediately, then we have an on-duty practitioner who would make [a] decision,” he said. “[They] would advise that actually you need to contact your GP immediately and if it’s an emergency, you may need to go to A&E, and if it’s really bad the mental health crisis team may need to come.”

Another student, who suffers from depressive episodes and panic attacks and who wished to not be named, claims they also had to miss an appointment because of illness and was told it would be rescheduled “but never heard from [Open Door] again”. The student added that the practitioner “ended the session 45 minutes in – I did not get the full hour that I’d waited weeks for.”

They went on to say that Open Door is “advertised as a counselling service, but they are not”, claiming that “students are being misled” because “the service apparently only wants to treat students who are failing their degrees rather than students who are unwell but can ultimately do their work”.

“I was then given some self-help that was really, really patronising, and read like it was targeted for a child who was a bit worrisome, which was not useful at all and just made me feel really demeaned and awful,” the student continued.

Open Door representatives affirm that the service is open to supporting all students and is not in a position to undertake treatment. Quinn emphasised that the service is “a study-orientated, enhanced provision that most universities put in place for students” and that there are “a range of different practitioners with different skills”, all fully qualified in their field.

A fourth student, who also wished not to be named, raised the question of whether the service could offer sustained, high quality therapy to everyone who needed it.

“It gets to the point after a couple of sessions where they’re like ‘So, do you feel like you’re okay now? Do you feel like you’re ready to move on from talking to us?’” they said. “People need to feel like they are welcome to come back again and again until they’re ready to leave…it was difficult going up and walking away feeling like I’d wasted their time.”

They continued that “The people [at Open Door] are amazing – the people I spoke to in those weeks made my life a lot easier in a dark time.”

Spending on Open Door increased by 9 per cent between 2011 and 2015 (adjusted for inflation), a significant proportional decrease when equated with a 46 per cent rise in demand over the same period. Quinn says the service currently accommodates 10 per cent of all students, and that is expected to rise to 12 or 14 per cent in the next year or two.

We’ve got a new practitioner who’s starting this term and three additional people who we’re bringing in to do additional sessions.

“Recently we’ve been given additional capacity,” Quinn said. “We’ve got a new practitioner who’s starting this term and three additional people who we’re bringing in to do additional sessions.” Open Door have also worked to increase workshops and group sessions at a college level, and each college has an assigned practitioner who works with JCRs.

The University is due to publish a report on the condition of the University’s mental health provision. University Registrar David Duncan said: “We have recently increased the resource available to Open Door in response to rising demand – new appointments have been made to strengthen the team and reduce waiting times.

“In addition, the Vice Chancellor recently commissioned a group led by Professor Hilary Graham from the Department of Health Sciences to write a report on student mental ill health and exactly how the University should be addressing it. That report will be considered by the Board in the near future, following which a statement will be issued.”

Quinn also added “If any student feels dissatisfied with their interaction with the Open Door Team they should feel free to contact their Practitioner or the Manager of the service in the first instance who will be able to look at issues raised and address them appropriately.

“The issues you mention have not been raised by any students with me, in spite of regular dialogue with a variety of individual students and groups, but should the students you spoke to wish to do so I would welcome the chance to understand their perspective and address them appropriately.

“Any student who is waiting for an appointment receives an email which provides contact details for Open Door and other services while waiting for an appointment. Students are encouraged to follow up on appointments and I hope the students you spoke to will now do so.”

Community and Wellbeing Officer Scott Dawson is pushing for a student consultancy with the Open Door Team to address concerns like those raised above.

2 comments

If any students would like to talk about their thoughts and feelings without judgement or being told what to do, they are always welcome to contact the active listening service, Nightline. While not the same thing as the Open Door Team, Nightline can be a useful source to get things off your chest and is open from 8pm-8am every night, when other services are closed. They are 100% confidential and respectful of anonymity and you can visit them at the New Building by the Charles XII pub, phone them on 01904 323735, instant message them at yorknightline.co.uk or email them at [email protected]. They’re also available at the Ron Cooke Hub Pod 3 on Mon and Thurs 8pm-11:30pm.

There are also other options if Open Door isnt quick enough for your needs. Qwell counselling is free online counselling and the York Healthwatch guide has lots of options in addition to the Online Services offered via Unity Health as well as the services recommended via York’s “Mind Your Head” site.

Anyone with Open Door dissatisfaction please do contact the Open Door team so they can be looked at.